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| DOE-HDBK-1078-94
This questionnaire example is not complete but provides a format model for evaluating trainee feedback at the
end of a course. (Note that the scale requires each trainee to evaluate and express an opinion about statements
relating to the training just received.)
Course/Program:
Date:
/
/
Name (Optional):
Instructor's Name:
Please circle the following statements using the following scale:
0 = N/A
--
Not Applicable Nor Observed
1 = SD
--
Strongly Disagree
2=D
--
Disagree
3=N
--
Neutral
4=A
--
Agree
5 = SA
--
Strongly Agree
N/A
SD
D
N
A
SA
1. Time allotted to each unit of
0
1
2
3
4
5
instruction was about right?
2. Examples, analogies, and topics in
0
1
2
3
4
5
training were relevant to my job
needs?
3. Training aids, audio-visuals and
0
1
2
3
4
5
handouts were current, accurate, and
relevant to my job needs?
4. As a result of attending the program
0
1
2
3
4
5
or course, I am better prepared to
perform my present duties?
5. The classroom setting helped to
0
1
2
3
4
5
promote learning?
6. Facility specifics were taught where
0
1
2
3
4
5
needed?
7. The classroom training I received was
0
1
2
3
4
5
beneficial to me in my understanding
of facility operations?
194
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